Individual
KRISTIN KAY PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHYSICAL THERAPIST
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
4473
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0326284
WA L&I
WA
01
—
0326297
WA L&I
WA
05
—
182952
—
OR
01
—
P01582590
RR MEDICARE
OR
Enumeration date
11/28/2005
Last updated
02/23/2016
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